January 12, 2010 - Katrina Case Alleges Negligence

Once the power blinked out, Althea LaCoste's lungs were on their own.

She struggled to breathe without the help of a respirator, and even a team of nurses hand-bagging air into her ailing lungs couldn't save her, according to court documents. LaCoste, 73, died before she could be evacuated from Pendleton Memorial Methodist Hospital in the chaotic days after Hurricane Katrina.

LaCoste's death 4 1/2 years ago is at the center of a civil lawsuit being heard here that could have far-reaching implications for hospitals across the country. The lawsuit against Methodist Hospital is the first civil suit alleging negligence of a hospital staff in Katrina's aftermath.

It could pave the way for future lawsuits across the country for how hospitals react to a variety of emergencies, from viral pandemics to street riots, says Sean Ahrens, a project manager with Aon Corp., a risk-management and insurance advisory firm to hospitals.

"A verdict against the hospital would open up a Pandora's box for other unrelated incidents," he says.

Lawyers representing the family say the hospital failed to adequately plan for the impending hurricane and are asking for $11.7 million in damages, according to court documents. Attorneys for the hospital say the event was an unforeseen disaster and beyond anyone's control. LaCoste was one of 16 patients who died at the hospital during Katrina. Lawyers for both sides say the judge has issued a gag order and they are unable to comment on the case.

In 2007, the state Supreme Court decided the case is not a malpractice lawsuit, opening the door to potentially unlimited damages. Louisiana has a $500,000 cap on malpractice lawsuits.

The LaCoste lawsuit could make hospitals across the country liable if their power gets knocked out by snowstorms, tornadoes or other calamities, says Edward Sherman, a Tulane University law professor following the case.

"I'm not at all sure hospitals in the past had thought about their liability for lack of emergency preparedness," he says. "This changes that."

Dozens of residents died in hospitals and nursing homes in and around New Orleans in the wake of Katrina. As overwhelmed rescue teams struggled to evacuate patients, many patients died of heart failure, heat exposure and stress.

In one of the more publicized cases, 45 corpses were retrieved from Memorial Medical Center in the city's Uptown neighborhood after Katrina. Dr. Anna Pou and two nurses were accused of hastening the deaths of some of the deceased, but charges against them were later dropped. A grand jury declined to indict Pou.

There have been 194 Katrina-related claims filed with the Louisiana Patient's Compensation Fund Oversight Board, a state agency that manages malpractice lawsuits, says Lorraine LeBlanc, the board's executive director. Three civil lawsuits are still pending against Pou, says her attorney.

The prosecutions against hospitals and medical staff could prevent doctors from helping out in disasters, says Pou's attorney, who, along with Pou, helped author and pass two state laws in 2008 protecting medical staff during declared states of emergency.

"All this has a chilling effect on people who may be caught in this situation," he says. "The result is you're going to have someone who can be saved with a ventilator dying and a doctor afraid to make a decision."

LaCoste was wheeled into Methodist Hospital on Aug. 28, 2005, the day before Katrina made landfall in Louisiana, according to court documents. She had congestive heart failure and was on a mechanical respirator.

When the hospital's generators flooded with the rising water and the power gave out, nurses took turns pumping air into LaCoste's lungs with handbags for 15 hours, the documents show. She eventually died "by the process akin to slow-drowning," according to her family's lawyers.

City health officials had earlier asked the hospital whether it had generators that could accommodate a 15-foot flood.

Cameron Barr, then-executive vice president, replied in an e-mail that has become case evidence: "The answer to that question is no."

Dr. Kevin Stephens, New Orleans's health director who initially raised the question of the generators, says he sympathizes with the hospitals and medical staff.

"We all want to do the best we can. That's why we're doctors," he says. "But we do have limitations. It's a tough, tough situation."